Yet drug-coated stents have become wildly popular, thanks in part to what The Annals of Internal Medicine describes as aggressive marketing and the unbridled expectations of patients. The path of least resistance in our litigious culture is to insert the stent. .The Texas Medical Board last month accused a widely known cardiologist in Austin of inserting unnecessary stents. 8300 Floyd Curl Dr Fl 4, San Antonio, TX 78229 (210) 450-9800. Copyright 2021. Im not an attorney, so I dont know whether a prosectuor has Often, if theyre moving too fast and Yes, Dr. Samin Sharma, MD holds board certification in Cardiology, Cardiovascular Disease and Internal Medicine. Dr. Sharma is board certified in Cardiology. Our Lady of Lourdes Regional Medical Center in Lafayette, Louisiana, provides another example of how high-volume rogue surgeons can escape scrutiny for years, either because hospital administrators dont know, or profit from pretending not to know, how dangerous they are. So having their personal incomes tied to the actual success of their unproven care isnt at all attractive. Drugs and a change of diet According to New York State Department of Health reports (since 1994), he has the highest angioplasty success rate and lowest mortality <0.2% for an interventional cardiologist in NY State, receiving numerous prestigious **star designation (significantly lower than expected mortality). arthritis, Type He has authored over 350 articles, 420 abstracts, 15 book chapters and three books to his credit. Dr. Sharma has developed a state of the art Heart Hospital (Eternal Heart Care Center, EHCC) in his native place Jaipur, India, which provides excellent care to all kinds of patients, including underprivileged and those living below the poverty level. . Obviously, the Mideis of the world could be caught by requiring that every cath undergo an independent second reading, Wacther adds. But some do set out to over-charge insurers, Medicare or Medicaid, and sometimes the patient suffers the collateral damage. I am afraid that many hospitals have resisted the news for one simple reason: procedures that involve stents are extremely lucrative. Meanwhile, just last fall, Dr. Eric Topol, chairman of the cardiology department at the Cleveland Clinic, warned Consumer Reports: Unfortunately, the extensive use of such stents is far ahead of the data that can be cited to support them.. As you know, a profit margin turns on the cost of operations. By contrast, pain from, say, arthritis, is both annoying and can negatively affect quality of life, but its not life threatening. can help the patient for a much longer period of time. president and chief executive, health system, president for academic affairs and dean, Icahn School of Medicine, president, Mount Sinai Downtown; system executive vice president and chief medical officer, chief financial officer and chief of corporate services, executive vice president and president of the health network, executive vice president and general counsel, executive vice president and system clinical affairs officer, executive vice president and system chief strategy and integration officer, executive vice president and system chief administrative officer, senior vice president, real estate and facilities, senior vice president and chief operating officer, chief medical officer, Mount Sinai Brooklyn; president, Mount Sinai Brooklyn, senior vice president and system chief risk officer, former trustee, medical board president, and gastroenterologist, president and chief operating officer, Mount Sinai Hospital and Mount Sinai Queens, senior vice president and chief financial officer, executive vice president and chief population health officer, senior vice president and system chief medical officer, senior vice president and medical director, senior vice president and executive director, Mount Sinai Hospital Queens. 2- Scanlon left at the end of 2020. In many cases, the malpractice insurance that was in force for the incidents had been acquired two decades earlier and had cash limits that were way too low for the settlements and judgements that were being given, leaving the pediatricians, many of whom had already retired, to pay 7 figure awards out of their own pockets. Sharma has built a 250-bed heart hospital (EHCC) in his native Jaipur, India to provide the best care to all patients irrespective of their financial and social status. The article reports that Samin Sharma, the director of interventional cardiology at the hospital, was paid $4.8 million by Mount Sinai in 2012: Kenneth Davis, Mount Finally, as I reported earlier this year, a more proactive Food & Drug Administration has announced that it plans to begin requiring drug makers and device makers to disclose details about their clinical trialsproviding detail on their failures as well as their successes. Sharecare, Editorial Oh, and by the way, it pays well too. According to the Sun: The 2007 study didnt find that stents are worthless, just that not implanting a stent can often be as good and avoids the real risks of complications or even death from the procedure. NIHCM Health Care Digital Media Award: the Finalists. Under health care reform, doctors are more likely to be looking over each others shoulders. How much is a visit to Dr. Samin Sharma M.D.? and treating thyroid eye disease, A I was told that I probably had a small heart attack sometime in the past and never realized it as there was some minor heart damage. 5- Several officers are listed on Forms 990 for multiple hospitals within Mount Sinai Health System. Dr. Samin Sharma, Mt. Major emphasis of the live course has been the technical aspects of safely performing complex coronary interventions. How well provider explains medical condition(s), How well provider listens and answers questions, Hpends appropriate amount of time with patients. He has authored over 350 articles, 420 abstracts, 15 book chapters and three books to his credit. Office 1190 5th Ave New York, NY 10029 Book by Phone+1 (828) 373-6811 Medical Journals Have Been Telling Us This for Years. health, Digestive Equity (Stock or stock options valued at greater than 5% ownership of a publicly traded company or equity of any value in a privately held company). For example, the Sun reports, "Dr. Mideis [use of stents] increased, by his own estimate, 50 percent, to about 1,200 a year., As for Mt. . This provider has 21 years of experience and is affiliated with Catholic View profile to see all. By the end of 2006 the hospital's total patient revenues had grown 41%, to $1.2 billion. Nephrology (Kidney) - Medical Arts & Research Center - MARC 210-450-9650; If you're a patient of Samin Sharma, And that 250,000 is considered an extremely low number, by those who understand the scope of the misbehavior. Mount Sinai's faculty policies relating to faculty collaboration with industry are posted on our website. Steamed Veggies or Raw Veggies for Healthy Cholesterol? Samin Sharma, M.D. Yes, but physicians rarely go to jail for malpractice. In the meantime, simply releasing payment information would help the press and public target such excess, as the WSJ piece on prostate care indicates. Finally, most patients (and even many physicians) tend to assume that, when it comes to medical technologies, newer means better. This is why, when asked to participate in a randomized clinical trial, some patients refuse, fearing that they will miss out on receiving what they assume is the newer, better product. I wonder if you might want to write a guest post about this? Windows, Condition Education The payments are risk-adjusted for age, gender, and health status. Patients may wish to ask their physician about the activities they perform for companies. (Medicare Advantage insures will be pushing back, refusing to overpay drugmakers, hospitals, etc.) Because physicians insurance participation can change, the insurance information on this page may not always be up-to-date. That can result in criminal charges and in permanent or temporary loss of the right to bill Medicare for services. Sign up here to receive e-mails alerting you when she has published new posts. Going forward, govts share will grow (as more people age into Medicare, and as as Medicaid and SCHIP expand). WebDR SAMIN SHARMA FAMILY FOUNDATION is a tax-exempt organization filed with Internal Revenue Service (IRS). disease, Crohn's COMPARISON OF THE MOUNT SINAI HOSPITAL INTERVENTIONAL OUTCOMES WITH NEW YORK STATE DATA: 20172021 Our Cardiac Catheterization Laboratory continues to serve the full range of cases, from the routine to the most complex Tools, Health Some physicians remain clearly undeterred by the research. . Established patients should expect a typical charge of $121.62 and an average copayment of 30.4. WebSamin Sharma; Samin Sharma, M.D. He has more than 100 publications and over 500 citings. device and biotechnology companies to improve patient care, develop new therapies and achieve scientific breakthroughs. Sharma wanted to let In September, federal prosecutors accused a cardiologist in Salisbury, Md., of performing unnecessary stent surgeries, and last year a Louisiana doctor was sentenced to 10 years in prison for inserting unneeded stents. He put two stents in almost immediately, said one grateful patient. Yet it wasnt until one of Patels fellow doctors at last secretly sued him in federal court under a special whistleblower law that the hospital revoked his admitting privileges. . cancer, Multiple Yet the odds that the bleeding-edge therapy represents an improvement over existing technology are only about 50/50. They are not repeated here. are more than atopic dermatitis, Understanding There, two rogue cardiologists, Chae Hyun Moon and Fidel Realyvasquez Jr., headed a team that performed extraordinary volumes of unnecessary and recklessly dangerous heart operations. Connect, Health whilst Im enthusiastic about CMS moving toward capitation, Im not holding my breath. In other words, governmetn is beginning to regulate prices. to prove intent, or whether there are cases where criminal negligence could put a doctor in jail. Please note that this information may differ from information posted on corporate sites due to timing or classification differences. If the first and second doctor each worked for the hospital with their compensation tied, at least in part, to the hospitals revenue and profit, Im skeptical how many times the first interventional cardiologist would be overruled. NG Go to a non-hospital-based doctor in the community. us, Community The popularity of stents is all part of a mindset that Drs. While I strongly support that approach, I suspect that, in the end, we may well wind up with an all payer system but Medicare and, especially, Medicaid will have to pay more than they do now. Medication doesnt work as rapidly. The main issue, in truth, is probably that the doctors believes that they are doing the right thing, based on their grasp of the science and their personal feelings about what they are doing, possibly influenced by personally not having kept up on the science and by the continued insistence of academic doctors with career stakes and of reps from supply, equipment, and drug companies that the evidence against the procedures are flawed, incomplete, or dont apply to a brilliant person like themselves who gets far better results than the people at institutions where the research is done . Health information on this site is not meant to be used to diagnose or treat conditions. Stent Scandal: A Shocking Story, But Not News, Center for Medical Consumers reported in 2006. A shocking number of them fall into the categories of Dangerous or Questionable.. Professional pride plays a role: doctors who implant stents firmly believe that they are helping their patients. Barry I had quintuple bypass surgery in 1999. But what I find most disturbing is that the story about Dr. Midei is not new; nor is it news. As Dr. Nortin Hadler, author of Worried Sick, argues in his guest-post below, medical research suggests that stents have been overused, nationwide, for years, exposing patients to needless risk and exorbitant expense. In fact, in most stent patients the stent most likely is responsible for the pain effects for only a fairly short time, at which point the maximal medical therapy they are almost always on as well takes over and carries most if not all of the weight. Not some thing I regularly read through, although I appreciate your views nonetheless. Dr. The powerful hospitals will vigorously resist value based insurance design though BCBS of Massachusetts is moving ahead with the introduction of a tiered in network insurance product on January 1, 2011. (Oh yeah, except for the ones regarding professionalism. Below are financial relationships with industry reported by Dr. Sharma during 2022 and/or 2023. Stents, you may remember, are those tiny metal scaffolds that cardiologists use to prop arteries open after they have been cleared of fatty deposits. Interventional cardiology became a key revenue source for Sinai. Over-Eating: Confusing Cause and EffectDoes Overeating CAUSE You to Re-Gain Weight, Or Do You Eat More BECAUSE You Are Overweight? MedPAC has found that the cost of operations at a great many hospitals is much, much higher than it needs to be. He performs angioplasty at New York's Mount Sinai Medical As to the sentence: it may be awkward because of the parenthetical phrase, but what it says, minus the aside, is: Dr. Sharma received the Governors Award of Excellence (2006), for his outstanding Why dont doctors police themselves and blow the whistle on bad doctors? , The Times went on to quote Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic: What was going on in Baltimore is going on right now in every city in America. Nissen added that he routinely treats patients who have been given multiple unneeded stents. Dr. Sharma has been the recipient of numerous awards for excellence from medical societies and the community, to name a few recent ones: 2014 Physician Scientist Award by AAPI-QLI, 2011 Ellis Island Medal of Honor, 2011 American Heart Association Achievement in Cardiovascular Science & Medicine Award, 2011 American Association of Physicians of Indian Origin (AAPI), 2010 Association of Indians in America (AIA) for Excellence in Medicine, 2010 Honored by AAPI forum of Tri-State Area for Academic Excellence, 2005-2008 and 2011-2021 Best Doctors, 2008-2021 Super Doctors, 2007 Jacobi Medallion Award at The Mount Sinai Hospital, 2007 Physician of the Year at The Mount Sinai Hospital. WebDr. rainmakers and this includes doctors who bring in revenues by doing too many surgeries (even when 3- Lorin was named President of Mount Sinai Brooklyn in May 2018. policy, Health No doubt many of the New Jersey insurers customersand some physiciansobject to the requirement. The CFO said their current margin on their Medicare business overall ranges from 0 to -10%. That hazingwhich includes being humiliated by people who are supposed to be You can find other locations and directions on Sharecare. Sinais King of Stents, ran a cath lab which was central to this campaign, performing procedures that typically brought in as much as $20,000 a piece for the hospital. Just one example: they have three or four ORs that are all very busy during the morning and more or less empty in the afternoon. More imporantly, when patients undergo angioplasty with stents, long-term repeated reserach shows that their chances of suffering a heart attackor dying from a haert attack are NOT REDUCED.. Barry Bob Wachter, Professor of Medicine and Chief of the Division of Hospital Medicine at the University of California, San Francisco, comments on the patient response: Most of his patients were probably quite content many had chest pain and a stent undoubtedly seemed like an appropriately aggressive, high-tech cure. Under the Affordable Care Act (ACA) bonuses will encourage doctors to move away from fee-for-service, and toward working on salary (as doctors already do at multi-specialty clinics such as Kaiser or the Mayo Clinic) or accepting capitated payments. 6- In March 2020 Ghandi was appointed chief financial officer of the health system. Well-Being, Well-Being (caps added to no for empnasis.). In 2009, Medicare paid just $3.5 billion for stent procedures nationwide, down from about $5 billion a year before the 2007 study was released. For capitation or bundled payments to work, they would need probably to be assured of total revenue equal or at least close to what they are generating today. management, Macular Under reform, accountability is likely to extend beyond the individual patient-doctor relationship. blow the whistle on other doctors. The stent story illustrates a major problem in our money-driven health care system. Wall Street likes them too. Sharecare, Editorial us, Close . Medication and change of diet, on the other hand, is much more likley to lead to long-term relief from angina. He currently practices at The Lauder Family Cardiovascular Center and is affiliated with Mount Sinai Beth Israel. He accepts multiple insurance plans. Maggie Dr Samin Sharma Family Foundation is a private foundation in Scarsdale, NY, which was founded in 2004 and most recently had $1 in revenue and no employees. Many at the hospital must have known what Midei was doing, he suggests, but looked the other way. What any cursory investigation reveals is truly jaw-dropping: 1. 2,500+ doctors are found responsible of Felony-level crimes each year another 5,500 convicted of lesser bad behavior. Dr. Samir Sharma has a 4.5/5 rating from patients. 2- Mo was president of Mount Sinai Brooklyn until mid 2018 and then transitioned to a role as executive vice president. Under the Affordable Care Act doctors who create a medical home also will be rewarded if they are able to keep their patients healthy and out of the hospital, while avoiding invasive treatments. A product of Crains New York Business. WebLocations. health, Transgender Perhaps the fact that the hospitals CEO and two other senior executives resigned after the case broke provides a clue as to who knew what when. In Massachusetts, Blue Cross/Blue Shield, which owns about 45 percent of the private insurance market in the state, already has moved to a combination of capitation and bonuses for higher quality care. This is because they are terribly inefficient. ] training you makes doctors extremely sensitive to criticism. Ordinarily, though doctors are not imprisoned for malprctice because society acknowledges that we all are human and even the very best doctors make mistakes. This provider has not specified a telehealth appointment method. Yes, the Redding story eptiomizes what has been happening. If a second doctor must sign off on the reading, this could stop a serial stenter in his tracks. ACOs certainly have the potential to do a better job with care coordination, especially if decent electronic records are in place and used. health, Exercise Certainly, hospital executive knew that they were making handsome profits on Mideis stent procedures. equity, Investor Dr. Sharma, his family, and other generous donors helped the Foundation reach its $5 million endowment, funding that will help support the labs clinical, research, and educational initiatives. Click on Contact Maggie on the blogs home page. The hospital subsequently agreed to pay a fine of $3.8 million but still denies it had any way of knowing about the safety or effectiveness of Dr. Patels care. But its not just that manufacturers over-estimated the benefits; they underestimated the new risk that the coated stent introduces. Hamburger As Director of Interventional Cardiology, Dr. Sharma oversees all Health System catheterization laboratories to maintain the highest level of care. Over the weekend, the New York Times published a head-turning tale about Dr. Mark Midei, a star cardiologist at St. Joseph Medical Center in Townson, Maryland. In other words, it seems that the hospital encouraged the doctor to implant those tiny mesh tubes in his patients arteries. Do you have any data on the percentage of stent placements that go into patients who are either asymptomatic or have stable angina? Sharma served on the Cardiac Advisory Board of New York State from 2004-2016, which advises the Health Department and the Governor on issues of health policies and supervision, safety, and appropriateness of heart care by various hospitals in New York. 2 "Other compensation" includes nonreportable compensation, deferred compensation, retirement-plan benefits, health care benefits and other fringe benefits from the organization and related organizations. Cardiologists dont perform caths on desert islands they are assisted by cath techs and nurses. If clearly unnecessary procedures are being done, especially when claiming that a blockage is much greater than the film shows it to be, the consequences for the doctor should be swift and severe including prosecution for fraud and, possibly, loss of his medical license. Samin Sharma, MD, is a specialist in internal medicine who treats patients in San Antonio, TX. He said that patients suffering from anginawho have never had heart attacks- undergo these procedures. (You will find the abstract here) Following a two-year study, researchers at the Cedars-Sinai Medical Center in Los Angeles are now suggesting that the putative superiority of drug-coated stents is founded on questionable premises. Or as The Wall Street Journal put it, the clinical trials of drug-coated stents (mostly funded by manufacturers), may have exaggerated their real-life advantage. [Dr. Midei was using a new generation of drug-coated stents.]. The Accountable Care Act allows the Secretary of HHS to lower fees for overvalued medical services. One would expect that she will take MedPACs advice and that especially in light of the Senate Finance Committee report, as well as legal action in a number of states, procedures involving stents would come under scrutiny. Malpractice insurance generally does not cover punitive damages. 4- Bruno left in October 2018. Finally, the new reform driven approach to pay hospitals modest bonuses if they meet certain quality standards is not likely to be as effective as you think or imply. WebDr. Back in 2003, THCB quoted a Stanford study which suggested that, over the long term, patients with multi-vessel disease would achieve better outcomes, at a lower cost, if they opted for the bypass operation. As Americans we tend to believe in whats newas if medical science progressed in a straight linear fashion, one breakthrough after another, from Madame Curie to me. It is always a good idea to verify your insurance when making an appointment. While looking at overtreatment, Dartmouth researchers realized that Redding was doing an extraordinary number of bypasses and angioplasties. Samin Sharma, Mt. He was then appointed as an attending at The Mount Sinai Hospital in 1990 where he is currently the Director of Interventional Cardiology (since 1996), Director of Clinical Cardiology (since 2011), Dean of International Clinical Affiliations (since 2011), President of Mount Sinai Heart Network (since 2011) and is the Anandi Lal Sharma Professor of Medicine, Cardiology. He attended and graduated from Wayne State University School Of Medicine I have no idea of what the percentages of people who are non-symptomatic who end up getting stents, but simple angina is the most common cause of heart cath and stenting in many centers. ), The problem is this, he concludes, as long as the cardiologist reading the cath is the one who pulls the trigger on the intervention, we have a potential Fox/Henhouse problem., What may be most troubling about the Medei imbroglio is that it highlights how our infatuation with high-tech medicine tempts us to ignore medical evidence. Home care, Digital policy, Press He also said that in the two years prior to this year, their costs per adjusted admission grew 3.5% with the comparable number for this year at 2.0%. Sinais King of Stents, ran a cath lab which was central to this campaign, performing procedures that typically brought in as much as $20,000 a . Cases like this one are terribly troubling, he continues, not just because they harm individual patients but because they do violence to the trust that is so fundamental to the physician-patient relationship. "Other compensation" includes nonreportable compensation, deferred compensation, retirement-plan benefits, health care benefits and other fringe benefits from the organization and related organizations. The lists include officers, trustees, directors and employees reported by each institution. Today, stents are used in 85% of all coronary interventions in the United States. Chest discomfort, especially if it occurs at rest and not during or shortly after eating is not only stressful, it can be perceived as life threatening. If the docs in other countries perceive, correctly, that, as a practical matter, they are unlikely to ever be sued, even if the screening results are positive, the patient may not be sent to the cath lab if he/she is non-symptomatic or has stable angina. sector, Brokers On the other side of the coin, stent patients have much higher incidence of problems related to stent failure, re-stenosis, and delayed stent complications, plus face the risk of acute complications, including death, during the procedure. 1- Officers' compensation was funded by Mount Sinai Hospital, Icahn School of Medicine, Mount Sinai Beth Israel, Mount Sinai West, and/or New York Eye and Ear Infirmary. Barry Court findings of fraud or willful negligence also expose the doctor to potential punitive financial damages, in addition to the usual compensatory damages.
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